Researchers have found the first evidence that a common cause of infertility in women is more prevalent amongst lesbians than heterosexuals, and they suggest that the biochemical disorder associated with the condition might contribute to the women's sexual orientation.

Polycystic ovarian syndrome (PCOS) is the commonest cause of ovarian dysfunction in women and is caused by an imbalance of sex hormones. One of the main features of PCOS is hyperandrogenism (male steroid hormones in women causing excess facial and body hair, deepening of the voice and loss of breast tissue), and now that the researchers have discovered the increased prevalence of PCOS amongst lesbian women they hypothesize that hyperandrogenism could be contributing to the women's sexual orientation.

Dr. Rina Agrawal, deputy medical director at the London Women's Clinic, examined 618 women who attended the clinic for fertility treatment between November 2001 and January 2003. Of these, 254 were lesbian and 364 were heterosexual women.

The women did not know whether they had polycystic ovaries (PCO) or PCOS before attending the clinic, but 15% of them had been treated previously for symptoms relating to PCOS such as irregular periods, inability to conceive, acne or excessive body or facial hair.

The women had a pelvic ultrasound examination on the second or third day of their menstrual cycle, and blood samples were taken to measure levels of reproductive hormones. A clinician, nurse and counsellor or clinical psychologist took details of their medical and sexual histories in three separate sessions.

The researchers found that the prevalence of PCO was 32% in heterosexual women and 80% in lesbian women, and that the prevalence of PCOS was 14% in heterosexual women and 38% in lesbian women. The average prevalence amongst all 618 women (lesbian and heterosexual) was 52% for PCO and 24% for PCOS. This compares with European data that show that the prevalence of PCO in the general population is 22% and 10-15% for PCOS, while 40% of all women who seek fertility treatment have PCO/PCOS.

The blood samples revealed that hormones such as testosterone, androstenedione, free testosterone index and luteinizing hormone (LH) were significantly higher, and sex hormone binding globulin (SHBG)[3] was significantly lower in lesbian women compared with heterosexual women. Dr. Agrawal said: "When we compared lesbian and heterosexual women with PCOS, lesbian women had significantly higher androgens and lower SHBG compared with heterosexual women. We found a similar result in women with PCO only, but in lesbian and heterosexual women with normal ovaries, the androgens and SHBG levels were similar."

She continued: "Our research neither suggests nor indicates that PCO/PCOS causes lesbianism, only that PCO/PCOS is more prevalent in lesbian women. We do, however, hypothesize that hyperandrogenism, which is associated with PCOS, may be one of the factors contributing to the sexual orientation of women."

However, the researchers are quick to dismiss any idea that if this was the case, then treatments for PCOS could also be seen as a "cure" for lesbianism. Dr. Agrawal said: "In 1973 the decision to remove homosexuality from the list of mental disorders was made and since then the focus has shifted from the 'cure' of homosexuality to the physical and psychological health concerns of these individuals. We do not view lesbianism as a disease that is in need of a 'cure'. The only aspects of health care we offer these women are reproductive health and assisted reproduction."

Previous studies have shown a similar prevalence of sexually transmitted diseases among lesbian compared with heterosexual women, but had not investigated the effect of this on the women's Fallopian tubes. Dr. Agrawal's study showed that there was a similar incidence of Fallopian tube disease in both groups. "The importance of this finding is to make clinicians aware that sexually transmitted diseases are just as prevalent in lesbian women as in heterosexual women. Previous studies have shown that at least 70% of lesbian women have been heterosexual or bisexual previously. Sexual practices amongst the remaining 30% who have never been heterosexual means that STDs can be transmitted between women sexually.

Dr. Agrawal concluded: "There are several challenges and gaps in the research and healthcare of homosexual people, and this in itself calls for focus and funding of this aspect of medicine. In the past 20 years only 0.1% of published articles were dedicated to the healthcare of homosexual individuals, and before 1990 homosexual people were invisible to healthcare research. Our study emphasizes the importance of treating these women in a non-judgmental and non-biased manner so that clinicians may offer them appropriate health advice. I hope that this study will provide an impetus and motivation to clinicians and reproductive endocrinologists to investigate and explore further the hypothesis outlined here."

That was a great article, Jennifer, thanks for posting it. I wonder if further study will find any correlation between homosexuality and early-onset PCOS during puberty, when the brain is most easily influenced by hormones. It will be interesting to follow

Thanks again - very interesting article. I'm glad the scientific community seems to be getting past their social bias in the last decade or so.

__________________Vanessa

Height: 6'0"
Current Measurements: 43.0"-32.0"-43.0"

Start Date: 5/17/04
HW/SW/CW/GW
230/216/188/150-160

Total loss thus far (8/13/04): 28 pounds 29.0 inches, 10% body fat

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This definitely makes sense to me. I believe, based on personal experience, that the elevated "male" hormones have a profound effect on the brain, as well as every other organ, as they obviously cross the blood-brain barrier. It would be interesting to know if Congenital Adrenal Hyperplasia, which can have a profound impact on the sex hormones starting in early childhood, is also associated with a higher incidence of lesbianism. If so, it would lend a lot of weight to the idea that lesbianism is biologically based.

At the same time, associating lesbianism with any disease condition is obviously politically volatile. It's too bad that the group of hormones under discussion are so strongly associated with "maleness" and "femaleness," as if these were absolutely binary, black-and-white states. These hormones actually have a profound effect on the body as a whole, from the skeletal system to muscle mass to fat deposits, entirely apart from reproduction and sexuality. It would be more correct to say that all human beings have a unique hormonal makeup and a correct personal balance of "male and female" hormones.

I totally agree on all points Seekinnerthinchick. The political side of this has the potential to get a bit messy, with people equating homosexuality with a disease. And you're right about the unique hormonal profile - there is a general range of "normalcy" with regard to hormones, but each person is different in ratios etc. and I don't think raised hormone levels should in and of themselves constitute a "disease" by the very meaning of the word. A disease is something gone awry that does not allow one to function normally, and homosexuality does not fit the profile. I myself am a "high-testosterone" woman even without the PCOS - I'm not diseased, just a little bigger and more muscular than average. It doesn't affect my daily life. I do appreciate the study for it's basis though - the study of infertility. With so many homosexual couples seeking IVF etc. it is an area of study worth merit. I just hope that in the future researchers continue to remain careful with how they interpret and publish results so that the ideology of homosexuality as a diseased state continues to go the way of the dodo.

By the way, to go a little off topic, I recently read a few studies regarding testosterone's effects on the brain en utero. It seems during fetal development testosterone must be converted to estrogen in order to affect the brain even in male children. I would be interested to see if any studies have been done on pubescent children in this regard as well and if it is perhaps the catalyst(s) of testosterone-estrogen conversion that masculinizes rather than testosterone itself in regards to neurobiology.

In any case I'm glad to see, in the recent decade or so, scientists take an interest in the homosexual population in regard to fertility and hormones that is not an attempt to "explain" or "cure", but rather to pinpoint mechanisms for the sake of improving understanding and well-being. I don't think it's entirely a bad thing - most heterosexuals are interested in the workings of their own sexuality and I'm sure homosexuals are too. Not to justify or try to "fix" but simply to understand out of curiosity. Like you said, though, there are plenty of ways to spin the results and people will interpret things in whatever way that allows them to avoid cognitive dissonance. I hope research like this doesn't give cause to mount another "cure the homosexuals" movement.

__________________Vanessa

Height: 6'0"
Current Measurements: 43.0"-32.0"-43.0"

Start Date: 5/17/04
HW/SW/CW/GW
230/216/188/150-160

Total loss thus far (8/13/04): 28 pounds 29.0 inches, 10% body fat

No trees were harmed in the transmission of this message. However, a few electrons were inconvenienced.

Vanessa: I agree. Although I have a selfish reason for following this research: my own testosterone levels! They have been at almost toxic levels in the past, e.g. male pattern baldness, enlarged larynyx, etc. I think, although I can't prove it, the testosterone surge started at puberty, which would account for why I grew 6" in less than a year, among other things. And from there to full-blown PCOS by the age of 16.

So getting the testosterone levels down has been a priority for me. One thing that may help: cutting out all sources of hormones, steroids, and act-alikes in the diet. I've noticed a lot of my hair problems have gotten much better since I cut way back on meat, especially beef. Currently I'm going to all-organic meat and milk to reduce my exposure as much as possible, while also reducing saturated fat from all sources. I'm hoping to get off Spiro entirely at some point, and be able to do more weightlifting without getting bulkier than I want to be, as muscle mass itself can stimulate testosterone production. I like having 120 pounds of LBM, I just don't want the beard and baldness. Finding a balance is a very tricky business with PCOS.